|
AIRWAY NASAL PVC 22FR
|
Facility
|
IP
|
$27.95
|
|
| Hospital Charge Code |
270676807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
|
|
AIRWAY NASAL PVC 24FR
|
Facility
|
IP
|
$26.00
|
|
| Hospital Charge Code |
270676808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.90
|
|
|
AIRWAY NASAL PVC 24FR
|
Facility
|
OP
|
$26.00
|
|
| Hospital Charge Code |
270676808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna Medicare Advantage |
$7.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.63
|
| Rate for Payer: Cigna Commercial |
$13.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.38
|
| Rate for Payer: Oxford Commercial |
$13.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.00
|
|
|
AIRWAY NASAL PVC LF 26FR
|
Facility
|
IP
|
$16.25
|
|
| Hospital Charge Code |
270638748
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$2.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.44
|
|
|
AIRWAY NASAL PVC LF 26FR
|
Facility
|
OP
|
$16.25
|
|
| Hospital Charge Code |
270638748
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$8.12 |
| Rate for Payer: Aetna Commercial |
$4.88
|
| Rate for Payer: Aetna Medicare Advantage |
$4.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.14
|
| Rate for Payer: Cigna Commercial |
$8.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.11
|
| Rate for Payer: Oxford Commercial |
$8.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.12
|
|
|
AIRWAY NASAL PVC LF 36FR
|
Facility
|
OP
|
$17.72
|
|
| Hospital Charge Code |
270638749
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$8.86 |
| Rate for Payer: Aetna Commercial |
$5.32
|
| Rate for Payer: Aetna Medicare Advantage |
$5.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.52
|
| Rate for Payer: Cigna Commercial |
$8.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.30
|
| Rate for Payer: Oxford Commercial |
$8.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.86
|
|
|
AIRWAY NASAL PVC LF 36FR
|
Facility
|
IP
|
$17.72
|
|
| Hospital Charge Code |
270638749
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.66 |
| Max. Negotiated Rate |
$2.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.66
|
|
|
AIRWAY NASOPHAR 22FR A4N156274
|
Facility
|
IP
|
$26.35
|
|
| Hospital Charge Code |
270627035
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$3.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.95
|
|
|
AIRWAY NASOPHAR 22FR A4N156274
|
Facility
|
OP
|
$26.35
|
|
| Hospital Charge Code |
270627035
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$13.18 |
| Rate for Payer: Aetna Commercial |
$7.91
|
| Rate for Payer: Aetna Medicare Advantage |
$7.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.72
|
| Rate for Payer: Cigna Commercial |
$13.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.43
|
| Rate for Payer: Oxford Commercial |
$13.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.18
|
|
|
AIRWAY NASOPHAR 36FR A4N1C6274
|
Facility
|
IP
|
$27.15
|
|
| Hospital Charge Code |
270627043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.07 |
| Max. Negotiated Rate |
$4.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.07
|
|
|
AIRWAY NASOPHAR 36FR A4N1C6274
|
Facility
|
OP
|
$27.15
|
|
| Hospital Charge Code |
270627043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$13.57 |
| Rate for Payer: Aetna Commercial |
$8.14
|
| Rate for Payer: Aetna Medicare Advantage |
$8.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.92
|
| Rate for Payer: Cigna Commercial |
$13.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.53
|
| Rate for Payer: Oxford Commercial |
$13.57
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$13.57
|
|
|
AIRWAY NASOPHARTNG 34FR 123034
|
Facility
|
OP
|
$20.27
|
|
| Hospital Charge Code |
270651075
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$10.13 |
| Rate for Payer: Aetna Commercial |
$6.08
|
| Rate for Payer: Aetna Medicare Advantage |
$6.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.17
|
| Rate for Payer: Cigna Commercial |
$10.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.64
|
| Rate for Payer: Oxford Commercial |
$10.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.13
|
|
|
AIRWAY NASOPHARTNG 34FR 123034
|
Facility
|
IP
|
$20.27
|
|
| Hospital Charge Code |
270651075
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$3.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.04
|
|
|
AIRWAY NASOPHARYN
|
Facility
|
OP
|
$44.84
|
|
| Hospital Charge Code |
270600863
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$22.42 |
| Rate for Payer: Aetna Commercial |
$13.45
|
| Rate for Payer: Aetna Medicare Advantage |
$13.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.43
|
| Rate for Payer: Cigna Commercial |
$22.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.83
|
| Rate for Payer: Oxford Commercial |
$22.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.42
|
|
|
AIRWAY NASOPHARYN
|
Facility
|
IP
|
$44.84
|
|
| Hospital Charge Code |
270600863
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$6.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.73
|
|
|
AIRWAY NASOPHARYN 28 FR
|
Facility
|
IP
|
$44.41
|
|
| Hospital Charge Code |
270600862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$6.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.66
|
|
|
AIRWAY NASOPHARYN 28 FR
|
Facility
|
OP
|
$44.41
|
|
| Hospital Charge Code |
270600862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.77 |
| Max. Negotiated Rate |
$22.20 |
| Rate for Payer: Aetna Commercial |
$13.32
|
| Rate for Payer: Aetna Medicare Advantage |
$13.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.32
|
| Rate for Payer: Cigna Commercial |
$22.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.77
|
| Rate for Payer: Oxford Commercial |
$22.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.20
|
|
|
AIRWAY NASOPHARYN 30 FR
|
Facility
|
OP
|
$37.65
|
|
| Hospital Charge Code |
270600604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$18.82 |
| Rate for Payer: Aetna Commercial |
$11.29
|
| Rate for Payer: Aetna Medicare Advantage |
$11.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.60
|
| Rate for Payer: Cigna Commercial |
$18.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.89
|
| Rate for Payer: Oxford Commercial |
$18.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.82
|
|
|
AIRWAY NASOPHARYN 30 FR
|
Facility
|
OP
|
$44.41
|
|
| Hospital Charge Code |
270600860
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.77 |
| Max. Negotiated Rate |
$22.20 |
| Rate for Payer: Aetna Commercial |
$13.32
|
| Rate for Payer: Aetna Medicare Advantage |
$13.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.32
|
| Rate for Payer: Cigna Commercial |
$22.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.77
|
| Rate for Payer: Oxford Commercial |
$22.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.20
|
|
|
AIRWAY NASOPHARYN 30 FR
|
Facility
|
IP
|
$37.65
|
|
| Hospital Charge Code |
270600604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$5.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.65
|
|
|
AIRWAY NASOPHARYN 30 FR
|
Facility
|
IP
|
$44.41
|
|
| Hospital Charge Code |
270600860
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$6.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.66
|
|
|
AIRWAY NASOPHARYN 32 FR
|
Facility
|
OP
|
$17.91
|
|
| Hospital Charge Code |
270601170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$8.96 |
| Rate for Payer: Aetna Commercial |
$5.37
|
| Rate for Payer: Aetna Medicare Advantage |
$5.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.57
|
| Rate for Payer: Cigna Commercial |
$8.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.33
|
| Rate for Payer: Oxford Commercial |
$8.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.96
|
|
|
AIRWAY NASOPHARYN 32 FR
|
Facility
|
IP
|
$117.65
|
|
| Hospital Charge Code |
270600859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.65 |
| Max. Negotiated Rate |
$17.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
|
|
AIRWAY NASOPHARYN 32 FR
|
Facility
|
IP
|
$17.91
|
|
| Hospital Charge Code |
270601170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$2.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.69
|
|
|
AIRWAY NASOPHARYN 32 FR
|
Facility
|
OP
|
$117.65
|
|
| Hospital Charge Code |
270600859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.29 |
| Max. Negotiated Rate |
$58.83 |
| Rate for Payer: Aetna Commercial |
$35.30
|
| Rate for Payer: Aetna Medicare Advantage |
$35.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.00
|
| Rate for Payer: Cigna Commercial |
$58.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.29
|
| Rate for Payer: Oxford Commercial |
$58.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.83
|
|